Borisenko Oleg, Lukyanov Vasily, Johnsen Søren Paaske, Funch-Jensen Peter
Dan Med J. 2017 Aug;64(8).
Bariatric surgery offers effective obesity treatment. The aim of this study was to evaluate the cost-effectiveness of bariatric surgery in Denmark from a third-party payer perspective in the mid- (ten years) and long-term (lifetime).
A state-transition Markov model was developed in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs and utilities were informed by the literature. Three types of surgery were included: gastric bypass, sleeve gastrectomy and adjustable gastric banding. The impact of different surgical methods on BMI level was informed by the Danish Obesity Surgery Registry (Dansk Fedmekirurgiregister).
In the ten-year base-case analysis, bariatric surgery led to a cost increment of 19,332 DKK and generated an additional 1.1 quality-adjusted life years (QALYs). In the course of a lifetime, surgery leads to savings of 36,403 DKK, an additional 0.7 life years and 2.9 QALYs. Bariatric surgery was cost-effective at ten years with an incremental cost-effectiveness ratio of 17,818 DKK per QALY and was dominant over conservative management in the course of a lifetime. Up to three years of delay in the provision of surgery resulted in a reduction of life years, a lower QALY gain and a minor decrease in healthcare costs.
In Denmark, bariatric surgery is cost-effective at ten years and may produce a significant reduction in healthcare costs over the course of a lifetime in persons with severe obesity.
Synergus AB received support for economic model development from Covidien AG (now part of Medtronic).
not relevant.
减肥手术是一种有效的肥胖治疗方法。本研究旨在从中期（十年）和长期（终身）的第三方支付者角度评估丹麦减肥手术的成本效益。
构建了一个状态转换马尔可夫模型，患者在模型中可能经历手术、术后并发症、2型糖尿病、心血管疾病或死亡。转移概率、成本和效用数据来自文献。纳入了三种手术类型：胃旁路手术、袖状胃切除术和可调节胃束带术。丹麦肥胖手术登记处（Dansk Fedmekirurgiregister）提供了不同手术方法对体重指数水平影响的数据。
在十年的基础案例分析中，减肥手术导致成本增加19332丹麦克朗，并产生了额外的1.1个质量调整生命年（QALY）。在一生的时间里，手术可节省36403丹麦克朗，增加0.7个生命年和2.9个QALY。减肥手术在十年时具有成本效益，增量成本效益比为每QALY 17818丹麦克朗，在一生中优于保守治疗。手术延迟提供长达三年会导致生命年减少、QALY增益降低以及医疗保健成本略有下降。
在丹麦，减肥手术在十年时具有成本效益，对于重度肥胖者，可能在一生的时间里大幅降低医疗保健成本。
Synergus AB获得了Covidien AG（现为美敦力的一部分）对经济模型开发的支持。
不相关。
